Laparoscopic Sleeve Gastrectomy for Morbid Obesity: The Future of Bariatric Surgery?

The incidence of obesity has significantly increased worldwide. Surgery has proven to be the most effective long-term treatment for sustained weight loss and improvement of co-morbidities in morbidly obese patients. Laparoscopic sleeve gastrectomy (LSG) is a relatively new procedure for weight loss with lower surgical risks, which is particularly suitable for those patients at highest risk for surgery, either because of their co-morbidities or their weight. LSG is being explored as a viable surgical option for treating morbid obesity, after simply being considered the first step of a staged procedure in super-obese/high-risk patients to allow some weight loss before a laparoscopic Roux-en-Y gastric bypass or biliopancreatic diversion-duodenal switch procedure. With the revelation that patients experience safe weight loss after LSG, interest in using this procedure as a bridge to more definite surgical procedures has risen. Outright reported benefits of LSG include the low rates of complications, the avoidance of foreign material, the maintenance of normal gastro-intestinal continuity, the absence of malabsorption, and the reduction of gherlin producing mass, accounting for its superiority to other restrictive bariatric surgical procedures. Although early results after LSG are promising in terms of short-term weight loss, more studies are required to evaluate the long-term durability of LSG especially effective weight loss, maintenance of weight loss, resolution of co-morbidities, and the potential of gastric tube dilatation with weight regain.